The Medical staff counselor
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In order to accomplish effective, objective peer review and quality assurance in the midst of concerns about confidentiality and malpractice, 12 widely-held, false assumptions about the nature of peer review and quality assurance must be discarded.
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Although most state courts to date have upheld the validity of exclusive contracts, this article points out that exclusive contracts still raise serious antitrust and corporate practice of medicine issues, and such contracts may not, in many cases, terminate the privileges of physicians already on staff. The medical staff is encouraged to become involved in determining whether any exclusive contract is warranted and whether medical staff bylaws should tie continued practice at the hospital to the existence of the contract.
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Hospitals are increasingly entering into exclusive contracts with physician to operate a hospital department. Physicians who are not parties to the exclusive contract are foreclosed from providing any of the covered services and, in most instances, from access to the hospital equipment and facilities necessary for rendering such services. This article focuses on the substantive and procedural legal issues that arise with regard to physicians whose privileges are reduced or terminated as a result of an exclusive contract arrangement and factors that will be considered by hospitals in negotiating exclusive contracts.
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In analyzing the effect of Patrick v. Burget upon peer review, the authors conclude that the decision was not "an atom bomb" and that physicians who wish to work for changes in state law to ensure the availability of the state action exemption for peer review actions will find substantial guidance in the decision.
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This article sets forth numerous insight and practical suggestions for conducting medical staff hearings in compliance with the Health Care Quality Improvement Act of 1986. The authors examine when a practitioner is entitled to a hearing, how to prepare for a hearing, and how the hearing itself should proceed, from the opening statement to the hearing panel's recommendation.